Locomotive syndrome - an independent risk of large BP variability in elderly hypertensives. subanalysis from the Japan Ambulatory Blood Pressure Prospective (JAMP) study

Background: Blood pressure variability is a risk for target organ damage, cardiovascular-and non-cardiovascular prognosis. Acute pain and psychological factors rise BP, however it is unknown if locomotive syndrome (LS), a major cause of frail elderly, and depressive state are associated with large BP variability (BPV). We tested the hypothesis that locomotive syndrome (LS) or depressive state is associated with large BP variability in the elderly hypertensives. Methods: In 85 elderly hypertensive subjects in Ohshima island (mean age, 79.2 years old; female, 62.4%), we performed ambulatory BP monitoring, and checked the risk for LS using the LS scale, and depressive states by self-rating questionnaire for depression (SRQD). The measure of ambulatory BPV was expressed by standard deviation (SD). Results: The median values of LS scale and SRQD were 14 (positive:S;16/100 points) and 5 (positive:S;16/54 points), respectively. LS scale, but not SRQD, was significantly associated with SD in daytime SBP (p<0.05). When dividing subjects into the quartiles of LS scale, LS scale was positively associated with SD in daytime SBP (p1⁄40.038). SD in daytime SBP in the highest quartile group was significantly higher than that in the lowest quartile group. The relationship remained significant even after adjusting for age, sex, and BMI (Figure). Conclusion: Locomotive syndrome was independently associated with large BP variability in elderly hypertensives living in the remote island.